阿尔茨海默病与血管因素
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摘要
目的：以人群为基础研究血管因素与AD是否存在病因联系，探讨AD的危险因素和保护因素，为AD的病因学研究提供线索。方法：在痴呆患病率调查人群的基础上，将402名AD患者纳入病例组，384名非痴呆老年人纳入对照组，以年龄、性别、受教育程度为匹配条件，进行m：n配对的病例一对照研究，条件Logistic模型进行单因素和多因素分析，检测血管因素有关变量与AD的关系。同时评估社会人口学因素、生活方式、吸烟、饮食习惯、环境暴露、家族史等变量对阿尔茨海默病(AD)的影响。结果：经多因素分析发现，与无中风史者比较，中风者患AD的危险为前者的2.91倍(P=0.0029)，随着中风次数的增加，患AD的危险有增加的趋势；与无高血压者相比，伴有高血压者患AD的危险性为前者的1.460倍(P=0.0978)；25-50岁食用油炸及高脂食品者与一月不足1次者相比，大于1次／月者AD危险为前者的1.564倍，(P=0.0263)，且随着频率的增加，患AD的危险有增加的趋势；与50岁以上饮茶1月不足1次者相比，每月饮茶1-3次者患AD的危险为前者的0.770倍(P=0.0004)，随着饮茶频率的增加，患AD的危险性减少。经济水平良好及50岁后种粮食是AD的保护因素(OR=0.542，P=0.0062；OR=0.509，P=0.0136)。结论：血管因素与AD存在关联。且血管因素对AD的危险或保护作用存在剂量-效应关系，除了中风不能确定外，符合血管因素在前、AD发生在后的时序关系。因此，血管因素与AD可能存在病因联系。此外，AD还与经济水平及农业暴露有关，说明AD是一多病因疾病，为在人群中预防和治疗AD提供了有益的线索。
Objectives: To investigate the risk of Alzheimer's disease (AD) associated with vascular factors and sociodemographic status, living style, smoking, eating habit, environmental exposure, family history of dementia. Methods: We conducted a population based, m:n matched case-control study on 402 AD patients, and 384 controls matched for age, sex and education. Univariate and multivariate analysis was conducted using conditional Logistic model. Results: In multivariate analysis , stroke history was found to have significantly effect on AD compared with those without stroke (0R=2.91, P=0. 0029) , and the OR(Odds ratio) for AD increased with the times of stroke. Compared with normal blood individuals, the OR for AD was 1.460 for those with hypertension (P=0. 0978) . the OR was 1. 564 for individuals of age 25-50 years old high fat intake more than once per month compared with those less than once per month. regular tea drinking habits (the OR was 0.770 for individuals drunk tea 1-3 times per month compared with non-drinker) were found to be protective factors for AD. High economic level and planting crop over 50 years old were protective factors for AD(OR=0. 542, P=0. 0062; 0R=0. 509, P=0. 0136) . Conclusion: This preliminary case-control study suggested that vascular factors are associated with AD. There is dose-response association between the vascular factors and AD. And the vascular factors are before AD occurs except stroke which cannot be ascertained. Vascular factors may be an etiology for AD. Besides, economic levels and planting crop over 50 years old also had association with AD. The study suggested that AD was a polyetiologic disease and it also benefited to therapy and prevention of AD.
Objectives: To investigate the risk of Alzheimer's disease (AD) associated with vascular factors and sociodemographic status, living style, smoking, eating habit, environmental exposure, family history of dementia. Methods: We conducted a population based, m:n matched case-control study on 402 AD patients, and 384 controls matched for age, sex and education. Univariate and multivariate analysis was conducted using conditional Logistic model. Results: In multivariate analysis , stroke history was found to have significantly effect on AD compared with those without stroke (0R=2.91, P=0. 0029) , and the OR(Odds ratio) for AD increased with the times of stroke. Compared with normal blood individuals, the OR for AD was 1.460 for those with hypertension (P=0. 0978) . the OR was 1. 564 for individuals of age 25-50 years old high fat intake more than once per month compared with those less than once per month. regular tea drinking habits (the OR was 0.770 for individuals drunk tea 1-3 times per month compared with non-drinker) were found to be protective factors for AD. High economic level and planting crop over 50 years old were protective factors for AD(OR=0. 542, P=0. 0062; 0R=0. 509, P=0. 0136) . Conclusion: This preliminary case-control study suggested that vascular factors are associated with AD. There is dose-response association between the vascular factors and AD. And the vascular factors are before AD occurs except stroke which cannot be ascertained. Vascular factors may be an etiology for AD. Besides, economic levels and planting crop over 50 years old also had association with AD. The study suggested that AD was a polyetiologic disease and it also benefited to therapy and prevention of AD.
引文
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